Dance Conditioning Camp Enrollment Form

Dance Conditioning Camp Registration

Katrina's School of Dance
Information for parents/guardians: Camp will be held July 7th-July 11th from 5pm-6pm each evening. Students will participate in this one hour class learning conditioning skills that will help them be the best in their sport. They will perform core stregthening, balance training, endurance training, flexibility training, body awareness and posture techniques, and strength training.

Children from the ages of 8-17 years old are eligible to participate. Your child does NOT have to be a student at Katrina's School of Dance to participate. That being said, the $50 fee for Dance Conditioning Camp is in addition to any tuition, shoe, and costume fees that are owed to Katrina's School of Dance tap, ballet, and jazz classes. This $50 fee will be due prior to the first class on July 7th. If you fail to pay the $50 fee by July 7th at 5pm, your child will not be eligible to participate in Dance Conditioning Camp.

Students will need to wear athletic clothing and tennis shoes for Dance Conditioning Camp. Students can bring a bottle of water for breaks. Hair will need to be pulled up and away from the face.
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Age*
Medical Conditions (If Applicable)
PARENT/GUARDIAN INFORMATION (1):
Parent/Guardian Name (1)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
PARENT/GUARDIAN INFORMATION (2):
Parent/Guardian Name (2)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Waiver, Release of Liability, and Agreement to Particpate
As legal guardian of the above named persons, hereafter, child I hereby consent to his/her participation in Jenine Sullivan's Dance Conditioning Camp at Katrina's School of Dance. I recognize that potentially severe injuries, including permanent paralysis or death can occur in any activity involving height or motion, including but not limited to dance, gymnastics, special events and camps. I understand that it is the express intent of Jenine Sullivan and Katrina's School of Dance to provide for the safety and protection of my child, while participating and in consideration for allowing my child to use these facilities, I hereby release Jenine Sullivan and Katrina's School of Dance's employees, demonstrators, senior level students and teachers from all liability for any and all damages and injuries suffered by my child while under the instruction, supervision or control of Jenine Sullivan and Katrina's School of Dance.

YesNo
Permission to Treat
As a legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while training at or performing at Katrina's School of Dance. This acknowledgment of risk and waiver of liability, having read thoroughly and understood completely, is signed voluntarily as to its content and intent. I confirm that my child is in good health and that I have medical insurance on my child and will provide coverage while he/she is enrolled. I hereby authorize simple first aid and sent to any x-ray, exam and medical or surgical diagnosis that is deemed necessary in case of emergency and release, discharge and covenant not to sue for any negligent medical efforts expended on my behalf or on behalf of the minor. I hereby agree to individually provide for all possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating at Katrina's School of Dance.

YesNo
Payment Policy
I understand that the $50 fee for Dance Conditioning Camp is due prior to the first class on July 7th at 5pm. If I enroll my child in Dance Conditioning Camp, I agree to pay this $50 fee. I further understand that if the fee is not paid before July 7th at 5pm, my child will not be eligible to participate. I understand that it is my responsibility to pay the camp fee of $50. The $50 fee cannot be prorated. There are no credits or refunds for missed classes. I understand that the $50 fee for Dance Conditioning Camp is in addition to any tuition, shoe, and costume fees that are owed to Katrina's School of Dance's tap, ballet, and jazz classes.

YesNo
Should be Empty:

Dance Conditioning Camp Registration

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION (1):

PARENT/GUARDIAN INFORMATION (2):

Waiver, Release of Liability, and Agreement to Particpate

Permission to Treat

Payment Policy